Type 2 Diabetes

Type 2 diabetes, also known as non-insulin-dependent diabetes, is a chronic metabolic disorder characterized by high blood sugar levels due to insulin resistance or insufficient insulin production. It is the most common form of diabetes, accounting for the majority of diabetes cases worldwide. Type 2 diabetes typically develops in adulthood but can also occur in children and adolescents.

Symptoms

The symptoms of type 2 diabetes may develop gradually and include:

• Frequent Urination (Polyuria): Increased frequency of urination, particularly at night.
• Excessive Thirst (Polydipsia): Persistent thirst and the need to drink large amounts of fluids.
• Increased Hunger (Polyphagia): Persistent hunger and cravings, even after eating.
• Unintended Weight Loss: Unexplained weight loss despite increased appetite.
• Fatigue and Weakness: Persistent tiredness, lack of energy, and generalized weakness.
• Blurred Vision: Blurred vision or changes in eyesight.
• Slow Healing: Slow healing of cuts, bruises, or wounds.
• Frequent Infections: Increased susceptibility to infections, particularly skin, urinary tract, and yeast infections.
• Tingling or Numbness: Tingling or numbness in the hands or feet (diabetic neuropathy).
• Darkened Skin Patches: Acanthosis nigricans, characterized by darkened skin patches, especially in the neck, armpits, and groin.

Causes and Risk Factors

Type 2 diabetes develops when the body becomes resistant to insulin or fails to produce enough insulin to maintain normal blood sugar levels. The exact cause is multifactorial, involving genetic and environmental factors. Some common causes and risk factors include:

• Obesity and Sedentary Lifestyle: Excess body weight, particularly abdominal obesity, and physical inactivity contribute to insulin resistance and the development of type 2 diabetes.
• Genetic Predisposition: A family history of type 2 diabetes increases the risk of developing the condition, suggesting a genetic component.
• Age: The risk of type 2 diabetes increases with age, especially after the age of 45.
• Ethnicity: Certain ethnic groups, such as African Americans, Hispanics, Native Americans, and Asian Americans, have a higher risk of developing type 2 diabetes.
• Prediabetes: Prediabetes, a condition characterized by higher than normal blood sugar levels but not yet meeting the criteria for diabetes, increases the risk of developing type 2 diabetes.
• Gestational Diabetes: Women who have experienced gestational diabetes during pregnancy are at a higher risk of developing type 2 diabetes later in life.

Diagnosis

Diagnosing type 2 diabetes involves several tests and criteria, including:

• Fasting Plasma Glucose (FPG) Test: Measuring blood glucose levels after fasting for at least eight hours. A reading of 126 mg/dL (7.0 mmol/L) or higher on two separate occasions indicates diabetes.
• Oral Glucose Tolerance Test (OGTT): Assessing blood glucose levels before and two hours after consuming a glucose-rich drink. A two-hour blood glucose level of 200 mg/dL (11.1 mmol/L) or higher confirms diabetes.
• Glycated Hemoglobin (HbA1c) Test: Measuring average blood glucose levels over the past two to three months. An HbA1c level of 6.5% or higher indicates diabetes.
• Random Plasma Glucose Test: Assessing blood glucose levels at any time of the day, without regard to fasting. A reading of 200 mg/dL (11.1 mmol/L) or higher, along with classic symptoms, indicates diabetes.

Treatment

The management of type 2 diabetes aims to control blood sugar levels and minimize the risk of complications. Treatment strategies may include:

• Lifestyle Modifications: Adopting a healthy diet, engaging in regular physical activity, and achieving and maintaining a healthy weight are essential components of managing type 2 diabetes.
• Oral Medications: Several classes of oral antidiabetic medications, such as metformin, sulfonylureas, thiazolidinediones, and DPP-4 inhibitors, may be prescribed to lower blood sugar levels and improve insulin sensitivity.
• Injectable Medications: In some cases, injectable medications like GLP-1 receptor agonists or insulin may be necessary to achieve adequate blood sugar control.
• Blood Sugar Monitoring: Regular monitoring of blood sugar levels helps individuals with diabetes track their response to treatment and make necessary adjustments.
• Education and Support: Diabetes education and support programs assist individuals in understanding the condition, managing medications, adopting healthy lifestyle habits, and preventing complications.

Complications

If left uncontrolled, type 2 diabetes can lead to various acute and chronic complications, including:

• Cardiovascular Diseases: The risk of heart disease, stroke, and peripheral artery disease is significantly increased in individuals with type 2 diabetes.
• Kidney Disease (Nephropathy): Persistent high blood sugar levels can damage the kidneys over time, leading to impaired kidney function or kidney failure.
• Eye Complications (Retinopathy): Damage to the blood vessels in the retina can cause diabetic retinopathy, potentially leading to vision loss or blindness.
• Nerve Damage (Neuropathy): Chronic high blood sugar levels can damage the nerves, causing pain, tingling, or loss of sensation, often in the feet and hands.
• Foot Complications: Nerve damage and poor blood circulation can increase the risk of foot ulcers, infections, and, in severe cases, amputation.
• Skin Conditions: Individuals with type 2 diabetes are more prone to developing skin infections, fungal infections, and certain skin conditions like diabetic dermopathy and necrobiosis lipoidica.

Prevention

Preventing or delaying the onset of type 2 diabetes is possible through lifestyle modifications and risk factor management. Prevention strategies include:

• Healthy Eating: Following a balanced diet rich in whole grains, lean proteins, fruits, vegetables, and healthy fats while limiting processed foods, sugary beverages, and saturated fats.
• Regular Physical Activity: Engaging in regular exercise, such as brisk walking, cycling, or swimming, for at least 150 minutes per week.
• Weight Management: Maintaining a healthy weight or losing weight if overweight or obese through a combination of diet and exercise.
• Blood Pressure Control: Monitoring and managing blood pressure levels to reduce the risk of cardiovascular complications.
• Smoking Cessation: Quitting smoking, as smoking increases the risk of various diabetes-related complications.
• Regular Check-ups: Undergoing regular medical check-ups to monitor blood sugar levels, blood pressure, and cholesterol levels.

See Also

• Type 1 Diabetes - Explore a chronic autoimmune condition characterized by a lack of insulin production.
• Gestational Diabetes - Learn about diabetes that develops during pregnancy.